Successful Vitamin D Project Aims to Change Standard of Care for Pregnant Women Across US

July 31, 2017
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Story at-a-glance

A two-year-long community project implemented at the Medical University of South Carolina confirms 40 to 60 percent of preterm births are prevented by raising pregnant women’s vitamin D to a level of 40 ng/mL

Vitamin D optimization also reduces the mother’s risk of preeclampsia, gestational diabetes and prenatal infections by approximately 50 percent

Children born of vitamin D-deficient mothers have higher risk of allergies and asthma, colds and flu, dental cavities, diabetes and autism, as well as a higher risk of stroke and cardiovascular disease in later life

By Dr. Mercola

Despite being simple and inexpensive to address, vitamin D deficiency is epidemic around the world. It's been estimated that if vitamin D levels were raised among the general population, it could prevent chronic diseases that claim nearly a million lives throughout the world each year. Raising vitamin D levels among pregnant women is of particular concern, as insufficiency affects both the mother and her developing child.

Protect Our Children NOW! is a GrassrootsHealth campaign launched in 2015 to combat vitamin D deficiency among pregnant women worldwide. Research by GrassrootsHealth shows 40 to 60 percent of preterm births could be prevented by raising pregnant women's vitamin D to a level of 40 nanograms per milliliter (ng/mL). This really seems to be the sweet spot, above which the risk for many complications and health problems dramatically decline.

Preterm birth is defined as a birth before 37 weeks' gestation. One of the reasons GrassrootsHealth created a field trial around pregnancy and preterm birth is because there's a clearly defined timeframe — babies either are or are not preterm, which makes the results unambiguous. Preterm birth is cited as the reason for 28 percent of newborn deaths during the first month of life.

Preterm babies are also more likely to suffer health problems later on, including a higher risk of ADHD, cerebral palsy, autism, asthma, intestinal problems, pneumonia, vision problems, hearing loss and dental problems. As of 2015, the U.S. had a preterm birth rate of 9.6 percent, meaning nearly 1 in 10 babies were born prematurely. The U.S., while one of the most advanced countries in the world, ranked No. 130 in preterm births out of 184 countries in 2010.

The Benefits of Optimizing Vitamin D During Pregnancy

Protect Our Children NOW! is a cost-effective, reproducible program that protects children by ensuring pregnant mothers are vitamin D sufficient. Aside from halving the risk for preterm birth, vitamin D optimization also reduces the mother's risk of preeclampsia, gestational diabetes and prenatal infections by approximately 50 percent.1

Research also confirms there is a lifelong impact for children born of vitamin D-deficient mothers, ranging from childhood allergies and asthma to more frequent colds and flu, dental cavities, diabetes, autism and even strokes and cardiovascular disease in later life. All of these conditions can be reduced by optimizing vitamin D during pregnancy.2,3,4

According to the 2015 Save the Children report5 on the health of mothers around the world, the U.S. ranked worst among developed countries. American women face a 1 in 1,800 risk of dying during pregnancy, and are more than 10 times as likely to die from pregnancy-related causes than women in Belarus, Poland and Australia. We now have an unprecedented opportunity to change this abysmal track record.

Protect Our Children NOW!

Protect Our Children NOW! was initiated by Carole Baggerly, founder of GrassrootsHealth,6 which has a panel of more than 40 vitamin D researchers that provide scientific advice. Dr. Carol Wagner, a neonatologist, is the lead principal investigator for Protect Our Children NOW! The program was initially implemented at the Medical University of South Carolina (MUSC), a federally qualified health care center.

Vitamin D supplements were made available to all pregnant women in 5,000 IU capsules, donated by Bio-Tech Pharmacal.Pregnant women residing in South Carolina were able to enroll in this community demonstration project at no cost. The insurers paid for the vitamin D tests. Now, the results are in and not only has it led to a successful change in practice at MUSC, but the data also confirms that vitamin D optimization does indeed reduce premature birth.

Every day, there are approximately 1,000 preterm births in the U.S. By making vitamin D optimization standard of care across the nation, that number could likely be less than 500. According to estimates by March of Dimes, each preterm birth has a price tag of about $50,000. By making this one simple change in care, the U.S. could save more than $9 billion per year, including $4.5 billion in Medicaid costs.

Over the past two years, Protect Our Children NOW! has created a successful template for standard of care that is now ready to be implemented throughout the U.S. in any hospital willing to participate. To start, the project needs your help to expand its support to at least three major hospitals and their pregnant populations.

To begin the implementation of the program, they need $200,000 this year. To fund all three hospitals, a total of $1 million is needed. I urge you to make a donation right now. By doing so, you will help save thousands of lives, and improve the health of both mothers and children.

Your Support Is Needed Now

I believe optimizing vitamin D during pregnancy is one of the most important things you can do for your and your child's health — it's so simple and inexpensive, and the benefits are so dramatic, it's really a no-brainer. Unfortunately, many women are still unaware of this simple strategy, and many doctors are also underinformed. Protect Our Children NOW! can change all of that, and I hope you will help them do just that.

So, please, make a donation right now, and I will match the first $25,000, dollar for dollar. I know we are constantly asking for your support but these are noble causes, and I would not ask if I were not donating first, so I appreciate your consideration.

One of the things that makes this initiative so exciting is that Blue Cross Blue Shield is helping at the state level and will be helping create some statewide educational programs. This is great news, since the high profile of this insurance company will increase the chances of eventually getting the standard of care changed nationwide. Blue Cross endorsement has the potential to EXPLODE this initiative across the country and could be a very strategic leverage of anything you are able to donate for support.

As with the initial South Carolina project, your donation will allow GrassrootsHealth to implement a "change in standard of care" for the entire pregnant population (an estimated 3,000 women per hospital) in each of the three hospitals for two years, after which the outcomes of each community project will be published.

The change in care includes vitamin D testing for all pregnant women upon their initial obstetrics visit. If their level is below the minimum target of 40 ng/mL, they will receive free vitamin D supplements. A second and third follow-up test will be administered about 8 to 12 weeks, and 24 weeks after the initial visit. Protect Our Children NOW! will also provide the following categories of support to participating hospitals:

A one-time grant to help pay for internal data collection and extraction, project leader compensation and ongoing implementation and communication with staff

Customization of infrastructure of the GrassrootsHealth protocol to meet the specific needs of the hospital and its community. This includes the institutional review board application within the hospital, definition of the measurements to be used to quantify results, custom literature, educational courses for their doctors and project management by GrassrootsHealth

Analysis of the health and lab test data by GrassrootsHealth on a bimonthly basis to a) provide ongoing direction to the local project manager and b) provide critical information to patients and to remind them of the need to take their supplements and to do their vitamin D tests at specified times. This methodology is key to the compliance of both patients and doctors with the program protocols

Disseminating outcomes through the creation of a scientific publication of the results; meeting with state and local officials to promote awareness and providing additional educational sessions

Research Supports Vitamin D Optimization During Pregnancy

The science supporting vitamin D optimization during pregnancy has been demonstrated in several randomized trials. To that, we can now add the large population study produced by the Protect Our Children NOW! project at MUSC. The results of this research were published July 24 in PLoS One.7 As noted in a recent press release:

"This first-of-its kind study demonstrated significant results by changing the standard of care for pregnant women. The goal was to help pregnant women achieve a vitamin D serum level of at least 40 ng/mL (100 nmol/L) — which has been demonstrated to be the threshold for benefit in previous randomized trials …

This population study included over 1,000 pregnant women at the Medical University of South Carolina. Results found that women who achieved a 25-hydroxyvitamin D serum level of ≥ 40 ng/mL (100 nmol/L) had a 60 percent lower risk of preterm birth compared to those with levels < 20 ng/ml (50 nmol/L).

Two randomized controlled trials with vitamin D and pregnancy outcomes and an associated post-hoc analysis by researchers at the Medical University of South Carolina (MUSC) showed a 59 percent lower risk of preterm births with 25-hydroxyvitamin D levels of ≥40 ng/ml (100 nmol/L) compared to women with concentrations ≤ 20 ng/ml (the current sufficient level recommended by the Institute of Medicine).

This new population study of all pregnant women at the medical center, using the implementation services of GrassrootsHealth and their Protect Our Children NOW! program, has confirmed that results can be replicated in a much larger population."

Among non-Caucasian women, the preterm rate prior to the start of the study was 18 percent. Those who achieved a vitamin D level of 40 ng/mL by their second test had a 78 percent lower preterm birth rate — reducing the preterm birth rate to just 4 percent!

GrassrootsHealth has also compiled data from its D*action participants and other partner institutions, which clearly shows that vitamin D serum levels do not increase linearly with dosage. For that reason, it's actually quite difficult to reach toxic levels, and no signs of toxicity were found in the study population. As noted by Baggerly:

"It is seldom that we find a solution to a major health problem that is demonstrably simple, safe and effective, but we have that here. Prevention is the key to health — not treatment of the disease. A hospital in Columbia, SC, Palmetto, is starting their implementation based on these findings. Funding is needed to continue this implementation. We hope you will help us support this initiative for the next generation of people."

Pregnant? Join GrassrootsHealth Study

If you are currently 12 to 17 weeks pregnant, you can join the join the GrassrootsHealth pregnancy study for free and test your vitamin D level from the comfort of your own home. If you are planning a pregnancy, or are more than 17 weeks pregnant, you can take control of your and your child's health by using the D*Action test kit. It's one of the most cost-effective ways to monitor your vitamin D status.

Keep in mind that while most prenatal vitamins contain some vitamin D, the amount is unlikely to be high enough to raise your level to 40 ng/mL. Also remember that the only way to ensure vitamin D is suffice is to get tested, and to tailor your dosage to achieve at least 40 ng/mL.

Ideally, you'll want to achieve a level of 40 ng/mL as early as possible in your pregnancy. Breastfeeding women should also supplement with 6,400 IUs of vitamin D3 per day to optimize your child's health.8